Law Enforcement Case No. File No. WARRANT FOR ARREST LID No. THE STATE OF NORTH CAROLINA VS. Race Sex Social Security No. Date Of Birth Age Drivers License No. & State FBI No. STATE OF NORTH CAROLINA I. FELONIOUS BREAKING AND ENTERING II. FELONIOUS LARCENY AND III. FELONIOUS POSSESSION Name And Address Of Defendant SID No. County In The General Court Of Justice District Court Division To any officer with authority and jurisdiction to execute a warrant for arrest for the offense(s) charged below: I, the undersigned, find that there is probable cause to believe that: I. FELONIOUS BREAKING AND ENTERING [G.S. 14-54(a)] On or about the date of offense shown and in the county named above the defendant named above did unlawfully, willfully and feloniously break and enter a building occupied by used as a located at with the intent to commit a felony therein: larceny. II. FELONIOUS LARCENY [G.S. 14-72(b)(2)] And, on or about the date of offense shown and in the county named above the defendant named above did unlawfully, willfully and feloniously steal, take and carry away Name Of Defendant's Employer Offense Code(s) I. 2212 II. 2356 III. 2341 Offense In Violation Of G.S. 14-54(a), -72(b)(2), -71.1 the personal property of having a value of $ and entering described in the charge above. Date Of Offense Date Of Arrest & Check Digit No. (As Shown On Fingerprint Card) III. FELONIOUS POSSESSION [G.S. 14-71.1] And, on or about the date of offense shown and in the county named above, the defendant named above unlawfully, willfully and feloniously did possess the personal property described in Count II above, which property was stolen property, being the personal property of the person, corporation, and other legal entity described in Count II above, and having the value described in Count II above, knowing and having reasonable grounds to believe the property to have been feloniously stolen and taken pursuant to the felonious breaking and entering described in Count I above. Complainant (Name, Address Or Department) Names & Addresses Of Witnesses (Including Counties & Telephone Nos.) This act(s) was in violation of the law(s) referred to in this Warrant. This Warrant is issued upon information furnished under oath by the complainant listed. You are DIRECTED to arrest the defendant and bring the defendant before a judicial official without unnecessary delay to answer the charge(s) above. Signature Date Issued Location Of Court Magistrate Deputy CSC Assistant CSC AOC-CR-103, Rev. 3/09 (Structured Sentencing) © 2009 Administrative Office of the Courts pursuant to the commission of the felonious breaking Clerk Of Superior Court Court Date Court Time AM (Over) American LegalNet, Inc. www.FormsWorkFlow.com PM District Attorney If this Warrant For Arrest is not served within one hundred and eighty (180) days, it must be returned to the Clerk of Court in the county in which it was issued with the reason for the failure of service noted thereon. The officer must state all steps taken by the department in attempting to PLEA: guilty execute the Warrant and any information obtained about the whereabouts guilty of the defendant. RETURN OF SERVICE I certify that this Warrant was received and served as follows: Time Served Date Served Date Returned Date Received AM PM By arresting the defendant and bringing the defendant before: Name Of Judicial Official This Warrant WAS NOT served for the following reason: Signature Of Officer Making Return Name Of Officer (Type Or Print) Waived Attorney For Defendant PRIOR CONVICTIONS: Appointed Not Indigent Retained No./Level: 0 I (0) II (1-4) guilty MISD. CLASS: 1 2 3 MISD. CLASS: guilty 1 2 3 guilty MISD. CLASS: guilty 1 2 3 not guilty not guilty JUDGMENT: The defendant appeared in open court and freely, voluntarily and understandingly entered the above plea; on the above verdict. It is ORDERED that the defendant: pay costs and a fine of $ . be imprisoned for a term of days in the custody of the sheriff. DOC.* Pretrial credit days served. Work release is recommended. is not recommended. [ is ordered. (use form AOC-CR-602)] The Court finds that a longer shorter period of probation, than that which is specified in G.S. 15A-1343.2(d), is necessary. Execution of the sentence is suspended and the defendant is placed on unsupervised probation* for months, subject to the following conditions: (1) commit no criminal offense in any jurisdiction. (2) possess no firearm, explosive or other deadly weapon listed in G.S. 14-269. (3) remain gainfully and suitably employed or faithfully pursue a course of study or of vocational training, that will equip the defendant for suitable employment, and abide by all rules of the institution. (4) satisfy child support and family obligations, as required by the Court. (5) pay to the Clerk the costs of court and any additional sums shown below. Fine Signature Attorney's Fee Community Service Fee Other $ $ $ $ *Name(s), address(es), amount(s) & social security number(s) of aggrieved party(ies) to receive restitution: REDELIVERY Date Restitution* $ Department Or Agency Of Officer III (5+) VERDICT: no contest no contest no contest Dep. CSC Assist. CSC CSC RETURN FOLLOWING REDELIVERY 6. complete hours of community service during the first days of probation, as directed by the community service coordinator, and pay the fee prescribed by G.S. 143B-262.4(b) within days. 7. not be found in or on the premises of the complainant or . . 8. not assault, communicate with or be in the presence of the complainant or 9. Other: I certify that this Warrant was received and served as follows: Time Served Date Received Date Served Date Returned AM PM By arresting the defendant and bringing the defendant before: Name Of Judicial Official This Warrant WAS NOT served for the following reason: Signature Of Officer Making Return Name Of Officer (Type Or Print) Department Or Agency Of Officer It is ORDERED that this: APPEAL ENTRIES The defendant, in open court, gives notice of appeal to the Superior Court. The current pretrial release order is modified as follows: Date Signature Of District Court Judge WAIVER OF PROBABLE CAUSE HEARING The undersigned defendant, with the consent of his/her attorney, waives the right to a probable cause hearing. Date Waived Judgment is continued upon payment of costs. case be consolidated for judgment with sentence is to run at the expiration of the sentence in . . COMMITMENT: It is ORDERED that the Clerk deliver two certified copies of this Judgment and Commitment to the sheriff and that the sheriff cause the defendant to be retained in custody to serve the sentence imposed or until the defendant shall have complied with the conditions of release pending appeal. PROBABLE CAUSE: Probable cause is found as to all Counts except No probable cause is found as to Count(s) for action by the grand jury. Date Name Of District Court Judge (Type Or Print) Signature Of Defendant , and the defendant is bound oer to Superior Court of this Warrant, and the Count(s) is dismissed. Signature Of District Court Judge CERTIFICATION I certify that this Judgment is a true and complete copy of the original which is on file in this case. Signature Of Attorney Date Date Delivered To Sheriff Signature Deputy CSC Assist. CSC AOC-CR-103, Side Two, Rev. 3/09 (Structured Sentencing) © 2009 Administrative Office of the Courts CSC NOTE: If DWI, use AOC-CR-342 (active) or AOC-CR-310 (probation). If active sentence to DOC, use AOC-CR-602. If supervised probation, use AOC-CR-604. American LegalNet, Inc. www.FormsWorkFlow.com